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Current concepts of migraine pathogenesis

J W Lance1

  • 1Institute of Neurological Sciences, Prince Henry Hospital, Sydney, Australia.

Neurology
|June 1, 1993
PubMed
Summary

Migraine involves a neurovascular reaction influenced by genetic predisposition and nervous system imbalances. Serotonin (5-hydroxytryptamine, 5-HT) is implicated in migraine genesis, with agonists potentially acting on cranial circulations.

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Area of Science:

  • Neuroscience
  • Pharmacology

Background:

  • Migraine is a complex neurovascular disorder.
  • Individual susceptibility is linked to a hereditary 'migrainous threshold' involving nervous system excitation-inhibition balance.

Purpose of the Study:

  • To elucidate the neurovascular mechanisms underlying migraine.
  • To explore the role of serotonin (5-hydroxytryptamine, 5-HT) in migraine pathophysiology.

Main Methods:

  • Conceptual review of trigeminovascular reflex pathways.
  • Analysis of the proposed role of serotonin (5-HT) in central and peripheral pain control.

Main Results:

  • Migraine mechanism involves an unstable trigeminovascular reflex with defects in pain control pathways.
  • Serotonin (5-HT) plays a significant role in migraine genesis, potentially acting on central pathways, cortical projections, or cranial blood vessels.

Conclusions:

  • Therapies targeting the trigeminovascular pathway can interrupt migraine phases.
  • Serotonin agonists may terminate migraine via cranial circulations, while prophylactic drugs might act centrally.

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